Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03464 | Date 21/11/2019 |
| Token No | SM/18-19/7641 21/11/2019 | Serial | 062 |
| Patient Name | Mrs. GHASIA SHAW | Contact No | 9439736859 |
| Address | 19 DOSTI LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||